Kornimate/medical-research-clean huggingface dataset:
maximizing the efficacy of cognitive behavior therapy and contingency management

Conditions: Marijuana Dependence

Summary: cognitive-behavioral coping skills therapy (cbt) is a widely used and recognized treatment that has been empirically validated for a range of substance use disorders, often with emergent effects and continuing improvement even after treatment ends. treatment retention and compliance are associated with enhanced treatment outcomes in cbt. contingency management (cm) also has very strong support and is associated with rapid, robust effects on targeted outcomes. despite their many strengths, neither cbt nor cm is universally effective. it is now essential to seek strategies to maximize and extend the effectiveness of these two approaches and to better understand how these treatments exert their effects.

the investigators propose to evaluate targeted strategies to maximize the effectiveness of cbt and cm, respectively. to maximize the effectiveness of cbt, the investigators will evaluate the benefit of adding cm, with reinforcement for session attendance and homework completion, to standard individual cbt for outpatient marijuana abusers, in order to expose participants to more skill training and opportunities for practice of skills. to maximize the effectiveness and durability of cm, we will evaluate the benefit of integrating it with skills training, specifically designed to reduce drop off effects, in order to extend cm's benefits beyond the active treatment period. we propose to conduct a stage ii trial which will: (1) evaluate the efficacy of four conditions for 160 marijuana dependent outpatients: (a) standard cbt, (b) cbt with cm reinforcement for attendance and completing homework (cbt+cm/adherence), (c) cm for abstinence alone (cm/abstinence), (d) cm for abstinence integrated with cbt (cm/abstinence+cbt), and (2) evaluate the longer-term durability and / or delayed emergence of treatment effects after termination of the study treatments through a one-year follow-up. secondary aims will be to conduct (a) detailed process studies to evaluate whether the proposed enhancements affect proximal and distal outcomes as hypothesized and (b) economic analyses. study treatments will last 12 weeks.

Eligibility criteria:
inclusion criteria: * 18-65 year old marijuana dependent * willing to sign consent * no use of prescribed psychotropic drugs * willing to give three individuals as contacts * willing to accept randomization * read and write english (third grade level) exclusion criteria: * unable to commit to 1 year follow up

Keywords: behavior modification cognitive behavioral therapy combination therapy drug abuse therapy drug addition human therapy evaluation psychotherapy clinical trial phase ii coping drug and alcohol abstinence longitudinal human study outcomes research outpatient care psychological reinforcement therapy compliance behavior and social research tag human subjects neuropsychological test patient oriented research
efficacy and safety of organoid-based drug sensitivity screening to guide the treatment of mcrpc patients progressed after first-line treatment

Conditions: Metastatic Castration-resistant Prostate Cancer

Summary: this observational study aims to learn about the effects and safety of organoid-based drug sensitivity screening in mcrpc patients with bone metastases that progressed after first-line treatment. the main question it seeks to answer is: do doctors choose treatment agents based on organoid-based drug sensitivity screening results for mcrpc patients, resulting in a better response? participants already took bone metastasis biopsies for genetic testing based on current clinical guidelines. this study only takes residual tissue from biopsies for organoid culture.


Eligibility criteria:
inclusion criteria: 1. willing and able to provide informed consent. 2. adult males from 18 to 75 years age. 3. history of histologically or cytologically confirmed adenocarcinoma 4. documented evidence of metastatic castration resistant prostate cancer (mcrpc) and progressed after first-line treatment at mcrpc. 5. evidence of target lesion in imaging studies. 6. ecog performance status 0-1 7. estimated survival≥12 weeks exclusion criteria: 1. do not meet the inclusion criteria. 2. under any other anti-tumor therapy like chemotherapy and/or immunotherapy. 3. receiving organ transplantation in the last 3 months. 4. participants with autoimmune diseases or history of hbv, hcv or hiv infection (acute). 5. participants with pneumonia. 6. severe concurrent illness or co-morbid disease that would make the subject unsuitable for enrolment 7. unwilling and unable to provide informed consent. 8. patients who are judged unsuitable for clinical trial participation by the investigators.
a randomized study comparing single agent gemcitabine intravesical therapy versus mitomycin c in patients with intermediate risk superficial bladder cancer

Conditions: Superficial Bladder Cancer

Summary: gemcitabine has been shown to be highly effective and well tolerated in the first and second line therapy, as a single agent or in combination therapy for treatment of metastatic transitional cell carcinoma. on the basis of gemcitabine clinical activity and good tolerability this drug has been recently tested in intravesical therapy. we consider gemcitabine as a good therapy candidate for patient with intermediate risk superficial bladder cancer. based on the phase i/ii clinical trials w are going to explore the efficacy and tolerability of gemcitabine in this setting, and compare it to mitomycin c which is widely used in this group of patients.


Eligibility criteria:
inclusion criteria: * histologically verified superficial transitional cell carcinoma of the bladder. * patients with primary or recurrent intermediate risk superficial bladder cancer after tur. patients with primary tumor with stage tag1 with multiple lesions (\>3) or lesions bigger than 3 cm or patients with tag2-3 or t1g1-2. * patients must not be pre-treated with any intravesical immunotherapy (bcg) or chemotherapy. * male or female, age greater than 18. exclusion criteria: * time between tur and start of intravesical chemotherapy will be longer than 4 weeks. * patients who have received previous (bcg) or chemotherapy. * patients with evidence of invasive, locally advanced or metastatic bladder cancer (greater than or equal to t2 disease; stage greater than or equal to b1) or patients with upper urinary tract disease.
nebulizer delivery of intranasal scopolamine

Conditions: Scopolamine; Motion Sickness

Summary: to develop a better way to administer anti-motion sickness medications using an intranasal nebulizer.

an aqueous scopolamine formulation is being administered via a nebulizer and the pharmacokinetics of the drug are being measured.

Eligibility criteria:
inclusion criteria: * male or female * adults age 21-49 * normal weight for body size, based on bmi table * general good health, as determined by a verbally provided medical history * normal brief neurological exam * renal and hepatic function within normal ranges * able to provide written informed consent to participate exclusion criteria: * drug allergies to scopolamine or other belladonna alkaloid * use of medications within 1 week of starting the study * use of an investigational drug within 30 days of starting the study * tobacco smoking within the past year * blood donation or significant blood loss within 30 days of starting the study * significant gastrointestinal disorder (e.g. crohn's disease, ulcerative colitis, chronic constipation), asthma, glaucoma, prostate problems, urinary obstruction, or seizure disorders * history of alcohol or other drug abuse * pregnancy or suspected pregnancy, or lactation (pregnancy will be confirmed with urine pregnancy testing prior to drug administration) * consumption of grapefruit juice within 7 days of scopolamine (scop) administration * nasal, nasal sinus, or nasal mucosa surgery within 90 days prior to study initiation * other significant surgeries within 90 days * significant deviated septum that blocks air flow in one nostril * rhinitis, sinus infection, severe allergies, and other upper respiratory infections within 30 days prior to the study * current use of an intranasal medication * wheezing or other respiratory problem * unable to consent * prisoner

Keywords: scopolamine motion sickness space physiology
azd7325 proof of concept in patients with generalized anxiety disorder (gad)

Conditions: Anxiety Disorders

Summary: the purpose of this research study is to determine whether astrazeneca's drug azd7325 is safe and effective in the treatment of generalized anxiety disorder.


Eligibility criteria:
inclusion criteria: * signed informed consent before any study-related procedures start. * the patient is previously diagnosed with generalized anxiety disorder. * the patient has a hads-a (anxiety) score ≥10 at both screening and randomization. exclusion criteria: * patient has a lifetime history of schizophrenia or other psychotic disorders * patient has a history of seizures or seizure disorder. * patient is pregnant or breast feeding. * patient has received electroconvulsive treatment (ect) in the past.

Keywords: generalized anxiety disorder gad anxiety
effect of holoblg on cat allergic patients

Conditions: Allergy to Cats; Allergic Rhinoconjunctivitis

Summary: the aim of the study is to investigate the antigen-unspecific effect of a 3 months supplementation with a food for special medical purposes (fsmp) in form of a lozenge containing beta-lactoglobulin (blg), iron, retinoic acid, zinc and polyphenols (holo-blg) in patients with allergic rhinoconjunctivitis caused by cat (hair/dander) and the associated symptoms (symptom type and severity) during exposure to cat allergen in an allergen exposure chamber (aec).


Eligibility criteria:
inclusion criteria: * at least 1 year of clinically relevant cat allergy * positive spt (wheal \>3mm) * positive npt * increase in tss \>3 during the 1st exposure in the aec * verbal and written consent exclusion criteria: * subjects \<18 years * subjects taking immunosuppressive drugs such as systemic corticosteroids, cyclosporine, etc. * subjects who have received or are currently receiving sublingual or subcutaneous immunotherapy (slit/scit) for cat allergy in the last 2 years prior to v0 * clinically relevant overreactions to the ingredients of holoblg, in particular subjects with a milk protein allergy or pronounced lactose intolerance * subjects with severe asthma and/or a history of uncontrolled asthmatic attacks in the last three months before the selection process (gina 4 and 5). * subjects with an fev1 \<70% (predicted value) prior to exposure in the aec * lack of verbal and written informed consent * subjects who are not proficient in the german language * history of serious chronic medical illness and/or any condition for which the local investigator believes that participation in the study could pose a risk to the individual * pregnancy and lactation * contraindications and/or history of adrenaline intolerance and/or emergency medications * concurrent use of anti-allergic medications and/or inadequate washout period of these anti-allergic medications prior to the selection process and exposure in the exposure chamber * tss ≥ 6 at t0 of first exposure in the aec * subjects who have a history of ingestion of holoblg
hospital wearable defibrillator inpatient study

Conditions: In-Hospital Cardiac Arrest

Summary: this study will obtain device-human interaction evaluations for the hwd1000 within the controlled environment of the hospital as well as establish that the safety profile is similar to outpatient wearable cardioverter-defibrillators use.

a multi-center prospective study of hospitalized patients whom a physician deems at risk of sudden cardiac arrest during the hospitalization period, wearing the hwd1000 hospital wearable defibrillator in order to evaluate caregiver and patient interactions with the device. in addition, ecg signal quality will be reviewed to confirm the hwd1000 safety profile.

Eligibility criteria:
inclusion criteria: patients whom a physician deems at risk of sudden cardiac arrest during the hospitalization period (patients will be monitored using the hospital's telemetry system). specific inclusion criteria are: * hospitalized patients having continuous independent ecg monitoring. * patients at risk of sudden cardiac arrest during the hospitalization period as determined by the investigating physician. * patient ≥18 years of age (over the legal age of providing consent). exclusion criteria: * patients with an active implantable cardioverter-defibrillator. * patients with an active unipolar pacemaker. * patients with physical or mental conditions preventing them from interacting with or wearing the device as determined by the investigating physician. * patients having an advanced directive prohibiting resuscitation. * patients having bandages or other clinical condition preventing the hwd use. * patients unable to consent. * patients having recently experienced an arrhythmic storm. * patients prone to paroxysmal supraventricular tachycardia.

Keywords: in-hospital cardiac arrest telemetry
real world data on management of male luts

Conditions: Benign Prostatic Hyperplasia

Summary: this study will describe the current medical care given to men who discuss their lower urinary tract symptoms with a hcp. it will document the primary reasons for the visit, the baseline characteristics of these men, the treatment received, and the practice patterns of specifically a primary care physician managing these patients.


Eligibility criteria:
inclusion criteria: * males, aged ≥18 years old. * having had discussion of urinary symptoms with their pcp between 15 days and 12 months prior to the date of the phone interview. * able to read, speak and understand english. * willing to provide informed consent for study participation, authorize the release of their previous 12-month medical records from their pcp for review and de-identified data entry by mapi into an electronic study database. exclusion criteria: * reported during screening that they had had their first-ever discussion of urinary symptoms with pcp within the 14 days prior to the date of the phone interview. * participation in a clinical research study that evaluated urinary symptoms in the past 12 months. * self-reported history of colorectal, bladder or prostate cancer. * self-reported neurologic disorders that affect bladder function, e.g., neurogenic bladder disorders due to spinal cord injury/disease, multiple sclerosis, parkinsons disease. * self-reported history of radiation therapy to the lower abdominal and/or pelvic region.
a randomized trial of behavioral economic approaches to reduce unnecessary opioid prescribing

Conditions: Acute Pain

Summary: in this study, the investigators will evaluate the effect of a health system initiative aiming to change clinician opioid prescribing behaviors using two behavioral economic interventions - individual audit feedback and peer comparison feedback of clinicians.

opioid-related abuse and overdose represent a growing national epidemic in the united states. clinician practice patterns play an important role: opioid prescriptions impact the likelihood that patients will misuse or become dependent on these medications, with longer prescriptions leading to greater sustained use. in this study, we will evaluate a sutter health system quality improvement initiative using monthly individual audit feedback and/or monthly peer comparison feedback to clinicians to change opioid prescribing patterns. in partnership with sutter health system, this will be conducted using randomization to evaluate its effect. we will also conduct a process evaluation to understand factors associated with better or worse performance at the clinician level.

Eligibility criteria:
inclusion criteria: * clinicians 1. practiced primarily at participating emergency department or urgent care center * patients 1. presented to a participating emergency department or urgent care center during the study period 2. discharged to home from the visit exclusion criteria: * clinicians 1. saw less than 100 patients in the prior year 2. practiced primarily at another site that is not in the main trial 3. did not practice at sutter health in the prior 90 days * patients 1. currently pregnant

Keywords: opioids nudges emergency medicine urgent care feedback
identification of bacterial and fungal isolates in patients with sinonasal polyps

Conditions: Sinonasal Polyps

Summary: to detect bacterial and fungal growth in patients with sinonasal polyps undergoing fess

chronic rhinosinusitis with nasal polyps (crswnp) is a disease of the nose and paranasal sinuses characterized by mucosal thickening and polyp formation¹ which are inflammatory lesions that project into the nasal airway and are typically bilateral² .chronic rhinosinsitis with nasal ployps (crswnp) affects 0.5% to 4% of the population worldwide. ³ symptoms include anterior or posterior rhinorrhea, nasal congestion, hyposmia, and/or facial pressure or pain that last for a duration of more than 12 weeks.² the cause of the sinonasal polyps is still unknown but they may be associated with several pathological conditions i.e. infection, allergic fungal sinusitis, allergy and cystic fibrosis ⁴. many studies were based on detection of bacterial and fungal growth in sinonasal polyps , and found that preoperative bacterial culture showed growth of staphylococcus coagulase negative (cons) ,staphylococcus aureus , gram -ve bacteria i.e. pseudomonas aeruginosa , klebsiella pneumoniae , klebsiella ozenae and escherichia coli⁴ . from fungi , aspergillus species were the most commonly recovered isolates ⁵. the initial approach of management was medical treatment . medical therapy consists of administration of intranasal or systemic steroids. other medical treatments considered the use of antibiotics, leukotriene modifiers, and avoidance of acetylsalicylic acid. surgical removal was performed for non-responders to medical management⁶. functional endoscopic sinus surgery (fess) is a minimally invasive technique in which sinus air cells and sinus ostia are opened under direct visualization. the goal of this procedure is to restore ventilation and normal functions⁷.

Eligibility criteria:
inclusion criteria: - 1. adult patients (18 and over ) 2. patients with sinonasal polyposis confirmed with nasal endoscopy and computed tomography and undergoing fess exclusion criteria: * 1.chronic rhinosinsits without nasal polyps 2. patients below 18 years old and above 70 years old 3. immunocompromised patient. 4. recent administration of antibiotics or antifungal medication . 5. unilateral nasal polyp , granuloma and tumors

Keywords: bacterial culture from patients with sinonasal polyi
anesthetic effect on immune cell in patients with cancer

Conditions: Breast Cancer

Summary: anesthetics agents has an effect on immune response during the cancer surgery.this influence can regulatory to immune activity or cancer cell survival. the purpose of this study is to prove the variation of immune cell activity between preoperative and postoperative period.

the patients were allocated randomly to receive propofol or sevoflurane. also, a total of 18ml of blood sample was obtained for total 3 times in consecutive order. 1. immediate before anesthesia induction 2. postoperative 1 hours 3. postoperative 24 hours immune cells isolation from patients peripheral blood mononuclear cells. next, immune cell were co-culture with human cancer cell line (mcf-7) for 24 hours. investigation for immune cell or cancer cell survival by flow cytometry.

Eligibility criteria:
inclusion criteria: * patient who was planned to undergo breast cancer surgery. exclusion criteria: * age \< 20 years old * history of hypersensitivity reaction in propofol or sevoflurane * history of previous cancer * patient with ongoing inflammation
general anesthesia versus locoregional anesthesia for evacuation of chronic subdural hematoma

Conditions: Chronic Subdural Hematoma

Summary: this study compare general anesthesia versus locoregional anesthesia for evacuation of chronic subdural hematoma. half of participant will be operated under general anesthesia, while the other half will be operated under locoregional anesthesia.

general anesthesia is the most common technique for this surgery. the local anesthesia is less common but it allows to obtain the same surgical result. this last technique being more recent little study compared these two techniques in terms of complications and postoperative consequences. the investigators will randomize patients into two groups (a general anesthesia group and a locoregional anesthesia group). general anesthesia provides complete immobility and optimal surgical comfort but is a source of multiple complications, especially in a population of polypathological and polymedicated elderly patients (which is the population affected by chronic subdural hematomas). locoregional anesthesia requires special technical training, leads to complete analgesia of the surgical procedure but does not involve complete immobility of the patient, however this technique probably leads to less postoperative complications and allows a more early rehabilitation.

Eligibility criteria:
inclusion criteria: * subdural chronic hematoma uni or bilateral * obtaining an oral consent * french speaker * affilliation to french social security exclusion criteria: * patients agitated or not cooperating, not allowing the realization of a locoregional anesthesia * patients with other intracranial lesions * patients with underlying neurological pathology with a modified rankin score greater than 1 * pregnant or lactating women * patients under guardianship / curatorship

Keywords: chronic subdural hematoma general anesthesia locoregional anesthesia length of stay